NDIKA FOMUKONG P.A.C
NPI 1497700066
Nurse Practitioner - Primary Care in Van Nuys, CA

Q: What is Ndika Fomukong's NPI number?

The NPI number for Ndika Fomukong is 1497700066. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Q: What is Ndika Fomukong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Ndika Fomukong was last updated on April 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 23, 2006PECOS Enrolled

6470 VAN NUYS BLVD STE D, VAN NUYS, CA 91401(323) 733-7242(310) 975-1292 Get Directions Write a Review

NPPES record last updated: April 10, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ndika Fomukong P.a.c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NDIKA FOMUKONG P.A.C (NPI 1497700066) is an individual primary care provider in Van Nuys, California, licensed in California (NP 17180) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1497700066

Entity TypeIndividualMale

Primary Taxonomy363LP2300X

Provider Legal NameNDIKA FOMUKONGCredential: P.A.C

Location Address6470 VAN NUYS BLVD STE DVan Nuys, CA 91401-1499

Mailing Address6470 Van Nuys Blvd Ste DVan Nuys, CA 91401-1499 · (323) 733-7242 · Fax (310) 975-1292

Phone(323) 733-7242

Fax(310) 975-1292

Sole ProprietorNo

Enumeration DateMay 23, 2006

Last NPPES UpdateApril 10, 2026

NPPES CertifiedApril 10, 2026

✔ NPI 1497700066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in CA · NP 17180

Also ListedPhysician AssistantTaxonomy 363A00000X · License PA17839 (CA)

6470 VAN NUYS BLVD STE D, Van Nuys, CA 91401

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ndika Fomukong P.a.c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ndika Fomukong's NPI number?

The NPI number for Ndika Fomukong is 1497700066. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Ndika Fomukong located?

Ndika Fomukong practices at 6470 Van Nuys Blvd Ste D, Van Nuys, CA 91401. The listed phone number is (323) 733-7242.

What is Ndika Fomukong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Ndika Fomukong enrolled in Medicare?

Yes. Ndika Fomukong is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Ndika Fomukong was last updated on April 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.